Gait patterns in patients with hereditary spastic paraparesis

Mariano Serrao, Martina Rinaldi, Alberto Ranavolo, Francesco Lacquaniti, Giovanni Martino, Luca Leonardi, Conte Carmela, Tiwana Varrecchia, Francesco Draicchio, Gianluca Coppola, Carlo Casali, Francesco Pierelli

Research output: Contribution to journalArticle

Abstract

Background Spastic gait is a key feature in patients with hereditary spastic paraparesis, but the gait characterization and the relationship between the gait impairment and clinical characteristics have not been investigated. Objectives To describe the gait patterns in hereditary spastic paraparesis and to identify subgroups of patients according to specific kinematic features of walking. Methods We evaluated fifty patients by computerized gait analysis and compared them to healthy participants. We computed time-distance parameters of walking and the range of angular motion at hip, knee, and ankle joints, and at the trunk and pelvis. Lower limb joint moments and muscle co-activation values were also evaluated. Results We identified three distinct subgroups of patients based on the range of motion values. Subgroup one was characterized by reduced hip, knee, and ankle joint range of motion. These patients were the most severely affected from a clinical standpoint, had the highest spasticity, and walked at the slowest speed. Subgroup three was characterized by an increased hip joint range of motion, but knee and ankle joint range of motion values close to control values. These patients were the most mildly affected and had the highest walking speed. Finally, subgroup two showed reduced knee and ankle joint range of motion, and hip range of motion values close to control values. Disease severity and gait speed in subgroup two were between those of subgroups one and three. Conclusions We identified three distinctive gait patterns in patients with hereditary spastic paraparesis that correlated robustly with clinical data. Distinguishing specific features in the gait patterns of these patients may help tailor pharmacological and rehabilitative treatments and may help evaluate therapeutic effects over time.

Original languageEnglish
Article numbere0164623
JournalPLoS One
Volume11
Issue number10
DOIs
Publication statusPublished - Oct 1 2016

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Spastic Paraparesis
gait
Gait
Articular Range of Motion
Ankle Joint
knees
Knee Joint
hips
Gait analysis
Hip Joint
Neurologic Gait Disorders
walking
Muscle
Kinematics
Chemical activation
Walking
pelvis
Therapeutic Uses
limbs (animal)
Pelvis

ASJC Scopus subject areas

  • Medicine(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Gait patterns in patients with hereditary spastic paraparesis. / Serrao, Mariano; Rinaldi, Martina; Ranavolo, Alberto; Lacquaniti, Francesco; Martino, Giovanni; Leonardi, Luca; Carmela, Conte; Varrecchia, Tiwana; Draicchio, Francesco; Coppola, Gianluca; Casali, Carlo; Pierelli, Francesco.

In: PLoS One, Vol. 11, No. 10, e0164623, 01.10.2016.

Research output: Contribution to journalArticle

Serrao, M, Rinaldi, M, Ranavolo, A, Lacquaniti, F, Martino, G, Leonardi, L, Carmela, C, Varrecchia, T, Draicchio, F, Coppola, G, Casali, C & Pierelli, F 2016, 'Gait patterns in patients with hereditary spastic paraparesis', PLoS One, vol. 11, no. 10, e0164623. https://doi.org/10.1371/journal.pone.0164623
Serrao M, Rinaldi M, Ranavolo A, Lacquaniti F, Martino G, Leonardi L et al. Gait patterns in patients with hereditary spastic paraparesis. PLoS One. 2016 Oct 1;11(10). e0164623. https://doi.org/10.1371/journal.pone.0164623
Serrao, Mariano ; Rinaldi, Martina ; Ranavolo, Alberto ; Lacquaniti, Francesco ; Martino, Giovanni ; Leonardi, Luca ; Carmela, Conte ; Varrecchia, Tiwana ; Draicchio, Francesco ; Coppola, Gianluca ; Casali, Carlo ; Pierelli, Francesco. / Gait patterns in patients with hereditary spastic paraparesis. In: PLoS One. 2016 ; Vol. 11, No. 10.
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AU - Martino, Giovanni

AU - Leonardi, Luca

AU - Carmela, Conte

AU - Varrecchia, Tiwana

AU - Draicchio, Francesco

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N2 - Background Spastic gait is a key feature in patients with hereditary spastic paraparesis, but the gait characterization and the relationship between the gait impairment and clinical characteristics have not been investigated. Objectives To describe the gait patterns in hereditary spastic paraparesis and to identify subgroups of patients according to specific kinematic features of walking. Methods We evaluated fifty patients by computerized gait analysis and compared them to healthy participants. We computed time-distance parameters of walking and the range of angular motion at hip, knee, and ankle joints, and at the trunk and pelvis. Lower limb joint moments and muscle co-activation values were also evaluated. Results We identified three distinct subgroups of patients based on the range of motion values. Subgroup one was characterized by reduced hip, knee, and ankle joint range of motion. These patients were the most severely affected from a clinical standpoint, had the highest spasticity, and walked at the slowest speed. Subgroup three was characterized by an increased hip joint range of motion, but knee and ankle joint range of motion values close to control values. These patients were the most mildly affected and had the highest walking speed. Finally, subgroup two showed reduced knee and ankle joint range of motion, and hip range of motion values close to control values. Disease severity and gait speed in subgroup two were between those of subgroups one and three. Conclusions We identified three distinctive gait patterns in patients with hereditary spastic paraparesis that correlated robustly with clinical data. Distinguishing specific features in the gait patterns of these patients may help tailor pharmacological and rehabilitative treatments and may help evaluate therapeutic effects over time.

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